Background checks
- The claim: "This bill also does not provide for any type of background check to be done on a person providing marijuana to the registered patient. Allowing persons convicted of drug crimes to actually hold drugs for a marijuana patient is a major problem and will likely violate their terms of probation."1
The facts: Under S.F. 345, which passed the full Senate last year, both primary caregivers and all employees of registered organizations are required to undergo background checks.
The proof: The relevant sections of the bill are below:
- Primary caregivers: "Before issuing a registry identification card to a primary caregiver under this section, the commissioner shall request a criminal history background check from the superintendent of the Bureau of Criminal Apprehension on the caregiver. The provisions of section 152.31, subdivision 7 apply to the background check. A person may not serve as a primary caregiver and a registry identification card may not be issued to the person if the person has been convicted of a drug felony as defined in section 152.31, subdivision 7, paragraph (a)." [Sec. 4, subd. 9]
- Registered organizations: "The department shall request a criminal history background check from the superintendent of the Bureau of Criminal Apprehension on all employees, agents, and board members of a registered organization. An application for registry identification cards for employees, agents, and board members must be accompanied by an executed criminal history consent form, including fingerprints." [Sec. 9, subd. 7(b)]
Privacy of registration data
- The claim: "This bill directs the Minnesota Department of Health to consider all registration data as confidential which means law enforcement officers will have no way of knowing who or which organizations have permission to lawfully grow or possess marijuana under this legislation, if enacted."2
The facts: This is a gross misrepresentation, or misunderstanding, of the way the blind registry system would work.
The proof: All qualifying patients, primary caregivers, and employees of registered organizations will be on file with the Department of Health, and will be issued a registration card with their photo and a unique identifier. The process for verifying the legitimacy of an individual or organization's participation in the medical marijuana program is clearly laid out in the text of the bill:
- "The commissioner shall maintain a list of persons to whom the commissioner has issued registry identification cards. Data in the list are private data on individuals or nonpublic data except that: (1) upon request of a law enforcement agency, the commissioner shall verify whether a registry identification card is valid solely by confirming the registry identification number." [Sec. 4, subd. 5]
Perceptions of marijuana and effects on teen use
The claims:
- "Legalizing marijuana for medical purposes will clearly lead to more illegal marijuana use and the crimes associated with it, endangering our youth and all of Minnesota's residents."3
- "Legalizing marijuana for medical purposes will lead many to conclude that the drug is in fact safe."4
- "The misperception that marijuana is harmless, which will be furthered by adopting this legislation, is perhaps most prevalent among teens where its use continues to be of significant concern. If youth perceive marijuana as harmless as a result of this legislation, increased use by children will surely result.
Based upon statistics compiled in 2002 and 2003 by the National Household Survey on Drug Use and Health:
- 8 of the 10 states with "medical" marijuana laws in effect in 2002 and 2003 showed a worse percentage change than the national average in monthly marijuana use by youth (12-17 years old) and 7 of these 10 states actually showed an increase in monthly marijuana use by such youth.
- 10 of the 12 states with "medical" marijuana laws in effect in 2003 were above the national average for first use of marijuana by youth (12-17 years old).
- 9 of the 12 states with "medical" marijuana laws in effect in 2003 were above the national average for monthly marijuana use by youth (12-17 years old)."5
The facts: Mr. Backstrom and his co-authors rely on old data and gross misrepresentations to paint a frightening picture that is completely at odds with all available evidence.
The proof: The authors present data from the 2002/2003 National Survey on Drug Use and Health (NSDUH) – though they erroneously call it the "National Household Survey on Drug Use and Health" – and claim that this data shows an increase in marijuana use by teens. However, they grossly misrepresent this data.
First, the authors misstate, or don't know, which states have effective medical marijuana laws. For instance, they
- cite data that was collected in 2002/2003 – when only 8 states had medical marijuana laws, not 10 or 12 as they claim;
- include Arizona and Maryland as medical marijuana states – they are not; and
- include Vermont and Montana as medical marijuana states, though their medical marijuana laws both passed in 2004, a full year after this data was collected.
Additionally, the NSDUH has since released data for 2005/2006. Why would the authors choose not to use the most recent data available to make their case?
At any rate, to gain any meaningful understanding about the effect of medical marijuana laws on usage, you have to compare data from before the law took effect to data after the law took effect. Simply looking at marijuana use in 2002/2003 – or any specific year – tells us nothing about the effect that the medical marijuana law had on the usage.
When such studies are compared, they show that teen use of marijuana is down in every medical marijuana state since that state enacted its medical marijuana law.
For instance, Hawaii passed its medical marijuana law in 2000. The 1999 National Household Survey on Drug Abuse (NHSDA) – as it was known before 2002 – estimated that 8.3% of Hawaii 12- to 17-year-olds used marijuana; the 2005/2006 NSDUH estimated that only 7.04% of Hawaii 12- to 17-year-olds used marijuana. That's a 15% decrease in marijuana use by Hawaii youths since the law passed.
Nevada also passed its medical marijuana law in 2000. The 1999 NHSDA estimated that 11.6% of Nevada 12- to 17-year-olds used marijuana, while the 2005/2006 NSDUH estimated that only 7.57% of Nevada 12- to 17-year-olds used marijuana. That's a 35% decrease in marijuana use by Nevada youths since the law passed.
As noted above, Vermont passed its medical marijuana law in 2004. The 2003/2004 NSDUH estimated that 11.11% of Vermont 12- to 17-year-olds used marijuana, while the 2005/2006 NSDUH estimated only 10.08% of Vermont 12- to 17-year-olds used marijuana. That's a 9% decrease in marijuana use by Vermont youths since its medical marijuana law passed.
Montana also passed its medical marijuana law in 2004. The 2003/2004 NSDUH estimated that 12.73% of Montana 12- to 17-year-olds used marijuana, while the 2005/2006 NSDUH estimated that only 10.56% of Montana 12- to 17-year-olds used marijuana. That's a 17% decrease in marijuana use by Montana youths since its medical marijuana law passed.
The NSDUH is not the only survey to measure teens' marijuana use. Many states – including California, Hawaii, Maine, Oregon, and Washington – conduct detailed state-level surveys with methodology similar to NSDUH, but they use far larger samples within each state. Also of interest is the Youth Risk Behavior Surveillance (YRBS), conducted by many (but not all) states in conjunction with the U.S. Centers for Disease Control and Prevention. In all of these state-level surveys, overall marijuana use by youths is down since the state passed a medical marijuana law. More than a decade after the passage of the nation's first state medical marijuana law, California's Prop. 215, a considerable body of data shows that no state with a medical marijuana law has experienced an increase in youth marijuana use since their law's enactment. In fact, all states have reported overall decreases – exceeding 60% in some age groups – strongly suggesting that enactment of state medical marijuana laws does not increase teen marijuana use.6
S.F. 345/H.F. 655 vs. Oregon's medical marijuana law
- The claim: "Testimony presented by the author of H.F. 655 indicated that this bill will impact only 150-200 seriously ill and dying persons in Minnesota. This testimony flies in the face of the experience in the state of Oregon after they adopted a law with a virtually identical definition of 'debilitating medical condition' as that proposed here in Minnesota."7
- "The definition of 'debilitating medical condition' under this proposal is far too broad. It includes any condition that produces 'chronic pain,' 'severe nausea,' or 'severe and persistent muscle spasms' - descriptions that could easily include chronic back problems or migraine headaches."8
- "The definition also includes any chronic or debilitating disease that causes severe or chronic pain, muscle spasms, nausea or seizures. This would include people suffering from arthritis, back or neck pain, migraine headaches or other similar problems."9
The facts: The Minnesota bill was amended over a year ago at the request of law enforcement, and the phrase "chronic pain" doesn't appear in the bill at all. Furthermore, Minnesota's proposed legislation has a much narrower definition of the term "debilitating medical condition" than Oregon's law – at the request of state law enforcement.
The proof: The primary diseases and conditions for which medical marijuana is authorized – for example, cancer, HIV/AIDS, and multiple sclerosis – are covered under all existing medical marijuana laws.
However, at the request of Minnesota law enforcement representatives, the bill's authors removed the phrase "chronic pain" and replaced it with "intractable pain, which is pain that has not responded to ordinary medical or surgical measures for more than six months," [Sec. 2, subd. 4(2)]. Such a definition clearly rules out non-serious back problems and migraine headaches.
But in correspondence to the Legislature on May 1, 2008, Mr. Backstrom ignores these amendments made more than a year ago and states that he and his colleagues "stand by" the "facts" contained in the claims listed above. This represents bad faith on his part at best. At worst, it's a blatant attempt to deceive the Legislature.
"Safe harbor"
- The claim: "Another section of the bill creates a safe harbor from arrest or prosecution for anyone 'in the presence or vicinity of the medical use of marijuana,' not just the 'qualifying patient.' This would hamper (if not outright prohibit) the ability to investigate and prosecute someone manufacturing, distributing, or possessing marijuana illegally, or any other criminal offense, while the person is in proximity to someone possessing a marijuana registry ID card."10
The facts: This is an unfounded charge based either on a misreading of the provision's intent or a desire to mislead policymakers.
The proof: To begin with, only registered organizations – not patients or their primary caregivers – will be permitted to "manufacture" (meaning, grow) medical marijuana under the bill. This has been the case since mid-2007.
The relevant section reads as follows: "No person is subject to arrest or
prosecution for any offense related to the possession of marijuana, including constructive
possession, conspiracy, aiding and abetting, or being an accessory, solely for being in the presence or vicinity of the medical use of marijuana as permitted under sections to
152.31 or, if the person is a primary caregiver acting in compliance with sections 152.22 to 152.31, for assisting a registered qualifying patient with using or administering marijuana."
The purpose of the section in question here is to ensure that family and friends of qualifying patients or primary caregivers do not face sanction solely for being nearby when their loved one possesses or takes his or her medicine. That is the intent and effect of this language.
Adverse impact on law enforcement
The claims:
- "Testimony presented by the author of H.F. 655 indicated that this bill is 'tightly crafted' so as to not adversely impact law enforcement or endanger residents and that persons using it will be under the care and scrutiny of a medical doctor. None of these things are true."11
- "As it sits now, this is not a medical intervention, but is the equivalent of a home remedy without any protection or assurances as to the safety of the patient or the public."12
The facts: In fact, each of the things mentioned in these claims are untrue, and it is utterly false to claim there are no protections or assurances of safety in the bill.
The proof: The bill's authors and proponents have made every effort to work with law enforcement, including granting them at least 19 concessions over the course of the committee process; however, they have remained steadfast in opposing this bill no matter how much it is altered to allay their concerns.
First, the bill will not adversely impact law enforcement. Despite similar concerns in many of the medical marijuana states prior to the passage of their laws, there has been no move to repeal any of the existing laws. As Terence Hallinan, the former District Attorney of the City and County of San Francisco (1996-2004), concluded in testimony submitted to the Minnesota Legislature: "In short, these are good laws that protect a limited number of people. In my experience, they do not increase the availability of marijuana to youth or in the criminal market generally, they do not result in additional cost to the state in terms of law enforcement resources, and they do not compromise our efforts to combat illicit marijuana use. In fact, the medical marijuana law actually reduced illicit marijuana dealing in some of our city parks. I would encourage the Minnesota Legislature to pass the medical marijuana bill and the governor to sign it. I would also discourage my counterparts in law enforcement from spending an inordinate amount of their time opposing this legislation. In time, they will find, as I did, that their concerns are largely unfounded."
Secondly, the medical marijuana law will not "endanger residents." These laws are extremely popular in the 12 other states, which certainly would not be the case if they were so dangerous to residents. S.F. 345 mandates a number of security measures on registered organizations; has extensive safeguards to prevent abuse; creates a blind registry of patients, caregivers, and registered organizations so law enforcement can easily check who is and who is not legitimately covered under the law; allows for state inspections of facilities; and drastically increases penalties on anyone who would misuse the program, far in excess of the existing penalties on recreational use.
And finally, patients will absolutely be under the care and scrutiny of their doctor. They will have to qualify for the program through a doctor's recommendation in the course of a bona fide doctor/patient relationship. The bill mandates that the certification itself will state that, in the medical professional's expert opinion, the benefits of the medical use of marijuana would likely outweigh the health risks for the patient. Making such a determination is what lies at the heart of the practice of medicine.
Major medical organizations reject medical marijuana
- The claim: "The use of smoked marijuana as a medicine has been rejected by the American Medical Association and, perhaps even more importantly, by the major medical organizations representing the groups of patients proponents say need it the most, i.e., the National Multiple Sclerosis Society, the American Glaucoma Society, the American Academy of Ophthalmology, and the American Cancer Society."12
The facts: This claim grossly misrepresents the positions of leading medical and public health groups.
The proof: The AMA, for example, supports more research and the right of doctors and patients to communicate honestly about medical marijuana's benefits and risks, and there's certainly nothing in their position that closes the door to the medical use of marijuana. Furthermore, the AMA has neither condemned state medical marijuana laws, nor have they urged states not to pass them.
Mr. Backstrom frequently cites the lack of a specific endorsement from these national groups as evidence of a lack of support from the medical community in general. While some of these groups, like the National Multiple Sclerosis Society, have officially rejected medical marijuana in the past, others have not. The lack of explicit support is not the same as opposition, and many of these groups have chapters and journals that have endorsed medical marijuana. Not one organization states that seriously ill patients should be subject to arrest and imprisonment for using marijuana with their doctors' approval.
In any case, all of the following organizations have explicitly expressed support for protecting patients from the threat of arrest and jail in states with compassionate medical marijuana laws:
Minnesota Organizations: Minnesota Nurses Association, Minnesota Public Health Association, Minnesota AIDS Project, and Minnesota Senior Federation.
National organizations: AIDS Action Council, American Academy of HIV Medicine (AAHIVM), American College of Physicians, American Nurses Association, American Public Health Association, Leukemia and Lymphoma Society, Lymphoma Foundation of America, National Association of People With AIDS, and United Nurses and Allied Professionals (Rhode Island).
State organizations: Alaska Nurses Association, California Medical Association, California Nurses Association, California Pharmacists Association, Colorado Nurses Association, Connecticut Nurses Association, Hawaii Nurses Association, Illinois Nurses Association, Medical Society of the State of New York, Mississippi Nurses Association, New Mexico Medical Society, New Mexico Nurses Association, New York State Association of County Health Officials, New York State Hospice and Palliative Care Association, New York State Nurses Association, Rhode Island Medical Society, Rhode Island State Nurses Association, Texas Nurses Association, Wisconsin Nurses Association, and Wisconsin Public Health Association.
It should be noted also that use of the phrase "smoked marijuana" by Mr. Backstrom is a red herring. Marijuana need not be smoked to be used as a medicine, as the American College of Physicians' position paper explains.
Alternatives to medical marijuana
The claims:
- "Currently there are many other medical substitutes that can be used to treat the same medical conditions that smoking marijuana is being proposed for."14
- "As noted above, many other drugs have been approved by the FDA and can be delivered in controlled quantities and qualities (unlike smoked marijuana) to treat the pain, nausea and other symptoms of the types of illnesses the use of marijuana is being proposed for in this bill."15
The facts: Even the best medicines don't work for everyone, or cause unacceptably severe side effects for some patients. The existence of alternatives is no reason to limit the options available to seriously ill patients. Even so, there are in fact debilitating conditions for which there is no FDA-approved medication at all, notably HIV/AIDS-related neuropathy.
The proof: First, in its landmark 1999 report, "Marijuana and Medicine: Assessing the Science Base," the Institute of Medicine – a non-governmental division of the National Academy of Sciences – states, "[T]here will likely always be a subpopulation of patients who do not respond well to other medications."16
And in a study published last year in the St. Paul-based medical journal Neurology, researchers concluded that marijuana is remarkably effective at relieving neuropathic pain in HIV and AIDS patients – a condition for which there are no FDA-approved medications at all.
Another clinical trial – this one conducted by researchers at the University of California – Davis Medical Center and published April 17, 2008 in The Journal of Pain – corroborated those previous findings. Based on the study's results, its lead author noted the possibility of "a therapeutic window that we could advise for using smoked cannabis in treating nerve injury pain."17
Finally, Mr. Backstrom almost invariably speaks of "smoked marijuana." In fact, patients do not need to smoke medical marijuana: In the existing 12 medical marijuana states, a growing number of patients use devices known as vaporizers, which allow the fast relief and ease of dose adjustment obtained with smoking, but without the tars and other harmful components in smoke. At least two published clinical trials and one observational study have verified the effectiveness of vaporization of medical marijuana.18 Patients can also opt to bake their medicine into food or make it into teas or tinctures as opposed to smoking it.
Marinol is medical marijuana
- The claim: "In fact, there already exists a legalized form of 'medical marijuana' in our Country - it's called Marinol."19
The facts: Marinol is not a "legalized form of 'medical marijuana'": It is a synthetic that contains only one of the more than 60 active components of marijuana, and is inferior to medical marijuana in a number of ways.
The proof: A clinical trial of marijuana published online on April 11, 2008 by the Journal of Pain noted, "When taken alone, 9-THC or dronabinol [Marinol] does not fully replicate the effect of the total cannabis preparation."
Further, in a double-blind, placebo-based study published on June 21, 2007 in the Journal of Acquired Immune Deficiency Syndromes, researchers from Columbia University found that it took doses of Marinol ranging from four to eight times the recommended dose to achieve almost the same results as the low-grade (3.9% THC and lower) marijuana provided by the National Institute on Drug Abuse (NIDA). Even at this elevated dose, Marinol was outperformed by natural marijuana on some measures.
In addition, Marinol is available only in pill form. Because of slow and uneven absorption, oral dosing is "the least satisfactory route" for administering marijuana or THC, according to a review published in May 2003 by The Lancet Neurology.20
Marinol, THC, and medical marijuana
- The claim: "The active ingredient of Marinol is synthetic THC, which is the main active chemical found within marijuana."21
The facts: THC is one of the main active chemicals in marijuana and a particularly valuable one, but research indicates that it does not in and of itself provide marijuana's medical benefits. To repeatedly insist that the existence of Marinol negates the need for medical marijuana is misleading and reflects a misunderstanding of the science.
The proof: THC is only one of about 66 active compounds in marijuana known as "cannabinoids." For instance, another cannabinoid, called cannabidiol (CBD), has been shown to contribute to marijuana's anti-nausea and anti-anxiety action, as well as marijuana's ability to protect nerve cells from several kinds of damage. This is just the start. Abundant research indicates that many of marijuana's medically useful properties result from these cannabinoids interacting synergistically to produce therapeutic effects that THC alone does not.
Marinol delivers appropriate dosages while medical marijuana does not
- The claim: "Marinol delivers therapeutic doses of THC in a manner that has been studied and approved by the medical community and the Food and Drug Administration. There is, therefore, no medical need to substitute a dangerous and addictive drug like marijuana for an approved prescriptive drug like Marinol that can provide a synthetic form of THC treatment with safe and controlled amounts."22
The facts: On the contrary, the issue of dosage is one of Marinol's primary problems and a key reason many medical organizations support protection for patients who use medical marijuana.
The proof: That Marinol comes with a set amount of its active compound per pill has little clinical relevance for several reasons. Absorption of THC taken orally is slow and uneven: This has been pointed out by a number of researchers, like NIH panelist Avram Goldstein, M.D., who explained that "the bioavailability is very good by the smoked route, and generally very predicable, whereas bioavailability by the oral route [pills] is both not good and not predictable in general."23 The Institute of Medicine reported in 1999, "It is well recognized that Marinol's oral route of administration hampers its effectiveness because of slow absorption and patients' desire for more control over dosing." The prestigious medical journal The Lancet Neurology also noted in May 2003 that "[o]ral administration is probably the least satisfactory route for cannabis."24
Secondly, while there is a set dose per pill, there is no clearly defined amount per patient. Marinol's FDA-approved prescribing information states that Marinol's effects are "subject to considerable interpatient variability. Therefore, dosage individualization is critical."25 No maximum dose is stated, and doctor and patient are allowed to adjust the dose as needed for relief. This is exactly what doctors and patients do with medical marijuana, except that when marijuana is vaporized or smoked, the relief is instantaneous and dose adjustment is simple to do.
Because Marinol is so hard to dose properly, patients often find it too intoxicating. This is reflected in the February 2008 position paper authored by the American College of Physicians, the second largest physicians group in the country and arguably the most prestigious. The ACP noted that Marinol's psychoactive side effects are "more severe" than those of inhaled marijuana, and patients frequently find it to be too intoxicating. Medical marijuana, on the other hand, allows patients to titrate their own dose, giving them greater control and the ability to limit the amount of medicine consumed.
Finally, THC is only one of about 66 active compounds in marijuana known as "cannabinoids." Abundant research indicates that many of marijuana's medically useful properties result from these cannabinoids interacting synergistically to produce therapeutic effects that THC alone – much less an isolated synthetic version like Marinol – does not.
FDA approval is needed to determine dosage and ensure safety
- The claim: "Without FDA approval there is no way to insure that the quantities of THC delivered by marijuana are measured and safe. In fact, there is no way to do this with the smoking of a raw plant that contains numerous other harmful chemicals."26
The facts: Medical marijuana allows patients to regulate their own consumption regardless of potency; FDA approval is certainly no guarantee of safety; and there are other ways to consume medical marijuana apart from smoking.
The proof: Because medical marijuana's effects are nearly instant, patients can easily adjust to changes in the potency of their medicine: They simply consume less of more potent medical marijuana. This is referred to as "titrating" one's dose: As NIH panelist Avram Goldstein, M.D., explained, "[B]y the smoking route, the person can self-regulate or titrate the dose."27
As for safety, unlike Vioxx and other FDA-approved medicines, no one has ever died of a marijuana overdose in 5,000 years of recorded medical history. As Francis Young, an administrative law judge with the Drug Enforcement Administration, noted in 1988 after hearing two years of testimony on the issue: "Marijuana, in its natural form, is one of the safest therapeutically active substances known."28
Also, it is important to note that between 40 and 60% of all prescriptions are written for drugs that have never been proved safe and effective for the condition they are being prescribed for. This practice, called off-label prescribing, is routine in medicine.
And finally, patients do not have to smoke medical marijuana. A growing number use devices known as vaporizers, which allow the fast relief and ease of dose adjustment obtained with smoking, but without the tars and other harmful components in smoke. At least two published clinical trials and one observational study have verified the effectiveness of vaporization of medical marijuana.29 Also, many patients in the 12 medical marijuana states opt to bake their medicine into food or make it into teas or tinctures as opposed to smoking it.
The FDA rejected medical marijuana in 2006
- The claim: "Please read the attached FDA statement on this issue before you pass into law a proposal that endangers Minnesota's residents."30
The facts: The 2006 FDA statement referenced here was dismissed by virtually all commentators as an obviously political, rather than scientific, document.
The proof: Any reference to the 2006 FDA "statement on the issue" is inherently misleading. The FDA did not conduct any new studies or analysis or even any conduct any new review of existing data before issuing its statement, even though much new research was available. In fact, the statement was issued at the request of U.S. Rep. Mark Souder (R-IN), perhaps the most vehement opponent of medical marijuana in the U.S. Congress, who wrote repeatedly to acting FDA Commissioner Andrew C. von Eschenbach. In one such letter, Rep. Souder wrote, "I am exasperated at FDA's failure to act against the fraudulent claims of 'medical' marijuana."
In the days after its release, more than 20 editorials rejected the FDA statement as a political, rather than scientific, document. For example, The New York Times wrote, "It's obviously easier and safer to issue a brief, dismissive statement than to back research that might undermine the administration's inflexible opposition to the medical use of marijuana."31 And the Chicago Tribune flatly stated, "The federal government has a long and dismal record of fighting the idea that marijuana has any medical value, and it is not about to let mere facts force a change in policy."32
Notably, Dr. John A. Benson, co-author of the Institute of Medicine's 1999 report on medical marijuana, reacted to the FDA's 2006 statement by telling The New York Times that the government "loves to ignore our report. ... They would rather it never happened." (NY Times 4/21/06)
Marijuana contains more carcinogens than tobacco
- Claim: "Smoking tobacco is harmful enough, smoking marijuana, which contains 50-70 percent more carcinogenic hydrocarbons than does tobacco smoke, is of even greater danger."33
The facts: Medical marijuana does not have to be smoked and, in any case, research indicates that the risk of pulmonary harm is far less severe than the author assumes based on extremely old studies.
The proof: First of all, medical marijuana that is consumed with the use of a vaporizer or ingested orally in foods, teas, or tinctures has zero hydrocarbons or tars and no risk of pulmonary harm, including lung cancer.
Secondly, if you read the footnote provided in the text, the authors actually cite 33-year-old research and ignore the mass of more recent evidence showing that marijuana smokers do not have higher rates of lung cancer than nonsmokers, and often tend to have lower rates, likely because of the documented anticancer activity of marijuana's active components, cannabinoids.34
Passage of S.F. 345 would conflict with federal law and lead to confusion
- The claim: "Consequently, current federal law is in conflict with the proposed medical marijuana law under consideration by the Minnesota Legislature. This will only subject Minnesota residents as well as law enforcement officials to conflicting and confusing laws, rules, roles and positions."35
The facts: The conflict with federal law has not resulted in much confusion in Minnesota with regard to existing marijuana laws, nor has it resulted in catastrophe in any of the 12 medical marijuana states.
The proof: First, there is no federal law that mandates that states must enforce federal laws against marijuana possession. States are free to determine their own penalties – or lack thereof – for drug offenses. In fact, Minnesota's law against marijuana possession is already different than the federal law, and no one is suggesting that this has caused profound confusion among residents and law enforcement officials.
Secondly, the programs in the other 12 medical marijuana states are up and running without the systemic confusion the authors believe will be inevitable.
For instance, in a report submitted to the Rhode Island Legislature, Charles Alexandre, the chief of health professions regulation, stated, "[T]he Department is unaware of any specific cost to law enforcement agencies or any litigation regarding the implementation of the [medical marijuana] Act ... [or] any prosecutions against physicians for violations of the Act."36
And according to a report prepared by Vermont's Marijuana Registry Program, Vermont Crime Information Center, Department of Public Safety, and the Vermont Department of Health:
- 90% of police managers surveyed reported that their department had "not incurred any additional costs as a result of the law," 84% said the law had "not made it more difficult to enforce drug laws," and 74% believed that the law had "not contributed to an increase in illegal marijuana use."
- Of those surveyed, no States Attorneys reported that their department had incurred any additional costs, and none felt that the medical marijuana law made it more difficult to enforce drugs laws or increased illegal marijuana use in general."37
The medical marijuana law will result in increased marijuana use
- The claim: "Legalizing marijuana for 'medical' uses will lead to increased illegal use of this dangerous controlled substance." 38
The facts: Suggesting that allowing registered organizations to cultivate a small number of plants for the patients' medical use will significantly impact the size of the illicit market is at odds with other states' experiences and with common sense.
The proof: For instance, Congress' General Accounting Office studied four states' medical marijuana laws and found that they had little or no effect on law enforcement in those states.
In California, Proposition 215 – that state's medical marijuana initiative – was passed in 1996. Statewide statistics for marijuana use for all age groups are not available prior to 1999. However, statistics on the use of marijuana by teenagers are available from the state-sponsored California Student Survey. This survey, available at http://safestate.org/index.cfm?navId=422, documents that teen marijuana use in California was rising prior to enactment of Proposition 215 in 1996 but has declined dramatically since then.
Furthermore, an analysis of the larger population commissioned by the California Department of Alcohol and Drug Programs found "no evidence supporting that the passage of Proposition 215 increased marijuana use during this period."
The medical marijuana law will result in increased marijuana distribution
- The claim: "First of all there will be no practical way to enforce the law to ensure that marijuana obtained for medical purposes is not used by other persons, including children."39
- The claim: "Consequently, there will be no way to ensure that those who obtain marijuana for a medical purpose will not share it with other persons."40
- The claim: "Also, because marijuana is a widely used illegal substance, incentives will exist for some unscrupulous persons involved in the sale or distribution of 'medical marijuana' to steal and distribute the substance for illegal uses."41
The facts: This is an unreasonable, irrelevant, and misleading standard.
The proof: If this were the standard we held the provision of medicine to, there would be no medicine left in the country aside from what a doctor or medical professional personally administers. There is no way to "ensure" that any medicine or prescription drug is not shared with others, aside from instituting penalties for breaking the law.
And in fact, the penalties for abusing the medical marijuana program provided in the bill are far steeper than penalties for simple recreational marijuana use outside of the program, removing any incentive to violate them.
Plant yields
The claims:
- "One marijuana plant can produce 1-2 pounds of smokeable marijuana, and the implementation of high quality production methods could increase plant yields."42
- "One ounce of smokeable marijuana can produce up to 56 marijuana cigarettes (joints), or 896 joints per pound."43
- "Using a low estimate of one pound of smokable marijuana per plant, passage of this legislation would allow authorized growers (registered organizations) to possess the equivalent of 10,752 marijuana cigarettes per 'registered qualifying patient'."44
The facts: Based on federal standards and estimates, the numbers provided by the authors for estimated plant yields are wildly inaccurate, and the overall implication – that the state would be flooded with marijuana as a result of this legislation – is misleading and false.
The proof: First, according to the United States Federal Sentencing Commission, the average yield for a marijuana plant is 0.22 pounds – significantly less than the 1-2 pounds of smokeable marijuana assumed above, and far less than the 1-5 pounds law enforcement has repeatedly stated was possible since the original publication of this document.
And, according to the National Institute on Drug Abuse (which provides pre-rolled marijuana cigarettes to the four surviving patients in the federal government's now-defunct medical marijuana program), a marijuana cigarette is 0.849 grams. An ounce of smokeable marijuana would generally come out to 33 cigarettes, significantly fewer than claimed.
Furthermore, the law only allows patients to possess up to 2 1/2 ounces of marijuana at a time. If the House adopts an amendment proponents agreed to in the Senate at the request of law enforcement, patients will also only receive that amount of marijuana every 15 days. There will be no flooding of the criminal market with medical marijuana. Further, the bill increases penalties for anyone who attempts to do so, taking away incentive to abuse the system.
By contrast, the 20-year-old federal medical marijuana program supplies four surviving patients with up to 300 grams (approximately 10 ounces) every four to six weeks.
Finally, the bill must allow these nonprofits to grow enough marijuana to serve their patients, or it would not be a functional system. However, they are only allowed to grow up to 12 plants per patient that registers with them, and the bill contains numerous safeguards to prevent diversion to the criminal market. Mr. Backstom's implication – that the bill is too loose and will allow marijuana to flood the criminal market – is simply false.
The "gateway theory"
The claims:
- "Many years of experience has shown us that marijuana is a key gateway drug to other drug use and addiction."45
- "Marijuana is a gateway drug to the use of other illegal drugs like methamphetamine, heroin and cocaine."46
- "Long-term studies of youth who use drugs show that very few young people use other illegal drugs without first trying marijuana."47
The facts: The "gateway theory" has been roundly debunked by many credible sources.
The proof: First of all, it is absurd on its face to cite a supposed "gateway effect" for patients who are already routinely prescribed opiates and other highly addictive, potentially deadly narcotics.
Furthermore, according to a 2006 study commissioned by the British Parliament, "the gateway theory has little evidence to support it despite copious research."
In 1999, the Institute of Medicine concluded, "There is no evidence that marijuana serves as a stepping stone [to other drugs] on the basis of its particular physiological effect."
The American College of Physicians noted in February 2008, "Marijuana has not been proven to be the cause or even the most serious predictor of serious drug abuse. It is also important to note that the data on marijuana's role in illicit drug use progression only pertains to its non-medical use."
And even the U.S. Department of Health wrote in its pamphlet "Marijuana: Facts for Teens," "Most marijuana users do not go on to use other drugs."
Increased Potency
- The claim: "Marijuana is much stronger now than it was decades ago. One study showed that the average THC levels in marijuana in the past two decades has increased from 6 percent to more than 13 percent, with some samples containing THC levels of up to 33 percent (which is far higher than the 1 percent potency levels in marijuana used in the mid-1970's)."48
The facts: While marijuana potency has increased over the course of the last 40 years, the increase has been far more minimal than law enforcement claims and, in any case, increased potency is generally a good thing for patients.
The proof: To start, the very notion of 1% THC levels is almost certainly wrong. This claim is based on a small number of marijuana samples that were stored for months or longer in hot evidence lockers, causing the THC to degrade and rendering the results unreliable. It is also absurd on its face: Marijuana with such low levels of THC has been shown to be non-psychoactive, producing no noticeable effect. Yet opponents would have us believe that the huge increase in marijuana use during the 1970s was based on marijuana that had little or no effect.
Furthermore, in April 2006, the Office of National Drug Control Policy (ONDCP) and the National Institute on Drug Abuse (NIDA) released an analysis of marijuana potency that found that the average amount of THC in seized samples has reached 8.5% – up from just under 4% in 1982. The dramatic shifts in average potency cited by Mr. Backstrom are simply not based in fact.
In any case, increased potency is an advantage for medical use, because those who choose to smoke are able to smoke less and achieve the same therapeutic effect. That's why the government of the Netherlands has set the minimum potency level for medical marijuana sold by prescription in Dutch pharmacies at 13% THC, with an 18% THC variety also available.
